Practice Management
A 35-year-old male with a history of end-stage-renal-disease (ESRD) presents to urgent care complaining of back pain. The patient missed his dialysis session today because of the pain. An ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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The Food and Drug Administration (FDA) recently added a boxed warning to the osteoporosis drug denosumab (Prolia) due to the heightened risk of severe hypocalcemia in patients with advanced chronic kidney disease (CKD). The agency’s decision, based on new evidence and a JAMA review, notes that denosumab increases the risk of severe hypocalcemia compared to bisphosphonates, particularly in CKD patients on dialysis. Severe hypocalcemia can manifest with symptoms like confusion, seizures, irregular heart rhythm, fainting, …
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